Healthcare Provider Details

I. General information

NPI: 1851813307
Provider Name (Legal Business Name): CAROLINE JUNE STUBBLEFIELD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2017
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 SPRING HILL AVE
MOBILE AL
36604-1405
US

IV. Provider business mailing address

PO BOX 40098
MOBILE AL
36640-0098
US

V. Phone/Fax

Practice location:
  • Phone: 251-665-8000
  • Fax: 251-665-8010
Mailing address:
  • Phone: 251-434-3473
  • Fax: 251-434-3757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-154699
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: